After fleeing persecution in his native land, Abdul Amin and his brother had lived for years in a camp in a nearby country.

When the U.S. accepted them as refugees in an Atlanta resettlement program, Amin, who spoke little English, may have thought at first that his nausea, inability to eat, and increasing emaciation were related to stress. Eventually, he sought medical attention, and a doctor at a nearby hospital diagnosed a gastric stricture and referred him to Emory University Hospital for Jahnavi Srinivasan’s surgical expertise in the condition.

Srinivasan did not believe the malnourished man could withstand surgery. Ordinarily, patients go home with a feeding tube to help them gain sufficient strength for surgery. Not Amin. The period of support from the resettlement agency was over. His brother, perhaps overwhelmed himself, declined to help. Srinivasan had little choice but to keep Amin in the hospital for preoperative nutritional support.

A month later, he had successful surgery. Since Amin’s only resources as an official refugee were a small Social Security check and limited Medicaid coverage, his medical care thus far was mostly unreimbursed. Post-surgical care required another two months of hospitalization and a concentrated effort from a team of physicians, nurses, technologists, and experts in metabolic nutrition support for Amin to improve. He still required tube feeding, but his intestinal system began to re-learn to manage food.

When it did, case manager and discharge planner Mackenzie Moore set about to find a place for Amin to live. Not a single person had come or called during Amin’s hospitalization. Eventually, his brother agreed to take him in. Moore worked out transportation, home health care, and help with Amin’s tube-feeding formula, none of which was covered by Medicaid.

The return home has not been easy for him, but he is growing stronger. And he now has one word of English he uses whenever he returns for a clinic visit. Thanks.